AB0297 EVALUATION OF FACTORS RELATED TO POSITIVE THORACIC COMPUTERIZED TOMOGRAPHY FINDING IN RHEUMATOID ARTHRITIS
Authors: S. Acer Kasman, M. E. Tezcan
Journal: Annals of the Rheumatic Diseases (2022)

Background Lung involvement is one of the common extra-articular involvements in rheumatoid arthritis (RA). There are some studies in the literature evaluating the risk factors related to lung involvement in RA. Male gender, smoking, seropositivity, uncontrolled disease activity, and long disease duration are the characteristics known for increased lung involvement in RA. There is ongoing debate about when and how we should screen RA patients for lung involvement. In addition, little is known about the importance of patients’ comorbidities as a risk factor for RA lung involvement. Objectives In this study, we evaluated the role of demographic and disease-related features and comorbidities as risk factors for positive lung computed tomography (CT) findings associated with RA lung involvement. Our aim here was not to evaluate the risk factor for RA lung involvement. Instead, we try to guide clinicians to risk stratification of RA patients for possible lung involvement. In previous studies, the authors compared risk factors between RA patients with and without known lung involvement. In addition, not all patients in these RA cohorts had thoracic CT. Therefore, they may miss preclinical or asymptomatic patients. In our study, we compared the characteristics of two groups of patients with and without positive thoracic CT findings. Methods We included 76 RA patients from our cohort who applied to our outpatient clinic for routine follow-up and had thoracic CT for any purpose in the past year. All RA patients met the 2010 ACR-EULAR RA criteria. Thoracic CT findings were classified as associated with RA according to the article by Esposito AJ et al. Patients with any known pulmonary involvement, malignancy, nursing, and known COVID-19 infection in the past year were excluded from the study. We divided the patients into two groups (positive or negative) according to thoracic CT findings. We compared the two groups in terms of patient and disease-related characteristics. We used qi-square test for comparing categorial variables and Mann-Whitney U test for comparing continuous variables. We then performed multivariate analysis with a model that includes significantly different features in univariate analyses and age to find the amount of risk attributed to the factors for positive thoracic CT. P&lt;0.05 was accepted as significant. Results Of the 76 (56.5 %) RA patients, 43 (56.5 %) had positive findings related to RA in thoracic CT (Table 1). Male gender (p=0.008), ACPA positivity (p=0.04), thyroid diseases (p=0.03) were found significantly more common in the patients with positive thoracic CT findings. The frequencies of all other demographic and disease related features and comorbidities are similar between the groups. Additionally, multivariate analyses found thyroid diseases (OR 6.1, %95 CI 1.5-24.3, p=0.009) and male gender (OR 7.8, %95 CI 1.6-35.7, p=0.008) were related to positive CT findings. Table 1. Positive thoracic CT features of RA patients n=43 (%) Pulmonary nodules 15 (34.8) Ground glass opacities 13 (30.2) Bronchial diseases 12 (27.9) Pleural diseases 9 (20.9) Mosaic attenuation 7 (16.2) Mediastinal lymphadenopathy 6 (13.9) Honey combing 5 (11.6) Emphysema 5 (11.6) Interstitial fibrosis 3 (6.9) Pulmonary vascular diseases 2 (4.6) Conclusion In our study conducted in our cohort, we found that male gender and thyroid disease were risk factors for positive thoracic CT findings associated with RA. Clinicians may consider these factors when classifying RA patients for lung involvement and planning thoracic CT for screening. References [1]Esposito AJ et al. Thoracic Manifestations of Rheumatoid Arthritis. Clin Chest Med . 2019;40(3):545-560. doi:10.1016/j.ccm.2019.05.003 [2]Kelly C et al. Current issues in rheumatoid arthritis-associated interstitial lung disease. Lancet Rheumatol . 2021;3(11):e798-e807. doi:10.1016/S2665-9913(21)00250-2 Disclosure of Interests None declared